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HomeMy WebLinkAboutMP24-110 C �° N � � a 00 00 p 6 ■ ~ N Q N wL 00 w a p tomb Ln en en o Q r,.1 H � v w O � � � H W 00 z N O A U u a� V - Z o .- t H w M H c°� z v � � o CA MCI M �'' t!� tea, o 00 0-4 a oZ v O w ~ z o w O o o v O a z - � 0 FO ti `� . � U 1� z M aq a{ d 0 W U V w o - q lu = z a O A u c � _ z d u8� o _ w t _ VILL FY BROOD BUI G DEPARTMENT AUG 2 0 2024 938 KING T Yl✓> OK,NY 10573 (914)939 rooks . ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL MODIFYAND/OR REMOVE MECHANICAL EQUIEPMENT -C, OFFICE USE ONLY;/�� � �/ // Permit#: `� �JJ Building Inspector: Application Fee: Date of Approval: Permit Fee: _& ro� Bldg/Use Class: Res. ( ); Comm. ( ); DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT: (A CERTIFICATE OF COMPLIANCE Is REQUIRED TO CLOSE OUT THIS PERMIT) 1.Properly Completed& Signed Application. 2. Payment of Application Fee: Residential=$100.00; Commercial=$250.00 (fees are non-refundable) 3. Site/Staging Plan as required by the Building Inspector. 4. Sealed Construction/Installation Documents & Specifications as required by the Building Inspector. 5. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder) & Workers Compensation Insurance on a NYS Board form (Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 6. Payment of Permit Fee: Residential=$18.00/1000.00 of Construction/Materials Cost with a minimum fee of$150.00. Commercial=$25.00/1000.00 of Construction/Materials Cost with a minimum fee of$275.00. 7.Inspection by Building Department for removal and/or installation. (48 hoar notice required) 8.Any electrical work requires a separate Electrical Permit and Electrical Inspection. 9.Any gas/plumbing work requires a separate Plumbing Permit and Plumbing Inspection. Application dated, ! is hereby made to the Building Inspector of the Village of Rye Brook,NY,for a permit for the installation,modification,and/or removal of the specific Mechanical Equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with the approved plans`,and with all applicable Local,County, State&.Federal laws,codes,rules and regulations. 1.Address: L I eJ►Yl SBL 3 1� Zone: 10 2.Property Owner: -TonL Ll Y1, Address; ' R Phone#: i 1 2 Cell#: email: [ n 15 1 GOY 3.Contractors:,ti—lo, Y V 1(�nJ nL L-C _Address: �(� VG 1 fN1 (_(�a �j< Phone#: GV- �. 9© `�10 9 Cell#: email: 4. Scope of Work:New Installation( )•Replacement( )•Removal( )•Other( ) gap 11 5.Type of Equipment: f in K1 M I t t - 1 0 6.Location of Equipment: 7.Cost of Equipment including Installation Cost: $ z rboo- I 611/2024X STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: SILA Services LLC ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work perforated,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 1? Sworn to before me this day of August* ,2024 day of 20 Qkk Signature of Property Owner Signature of Applicant Xinbo Liao SILA rvices LLC Print Name of Property Owner PriiL ant NoM JA cciNonnecticutiJotery ExpiresMyCa026 This application must be properly completed in its entirety and must include the notarized signature(s)of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. 2 6/l/2024